Number and order of whole cell pertussis vaccines in infancy and disease protection.

lowing negative studies. Despite studies showing that echinacea does not treat cold symptoms, it is one of the best selling supplements in the United States with estimated sales exceeding $300 million per year. Dr Leach claims that I supported my position “through the selective reporting of a few clinical studies.” However, all studies are not equal. The studies I selected regarding gingko, chondroitin sulfate, glucosamine, garlic, St John’s wort, milk thistle, and echinacea were the best controlled, most rigorous, and most internally consistent. Indeed, most of these excellent studies were supported by NCCAM. Briggs and Killen and Leach argue that refraining from studying alternative medicine would deny the public muchneeded clinical data to make informed health care decisions. In a better world, of course, this discussion would not be happening. In a better world, dietary supplements and alternative therapies would be subject to testing before claims were allowed, as is required by the US Food and Drug Administration (FDA) for licensure of drugs, biologicals, and medical devices. Now patients are stuck with a system in which some alternative medicines might be tested after claims have been made and after nutraceutical companies have spent millions of dollars “educating” the public. At best, NCCAM functions as a post-hoc FDA, except without the FDA’s regulatory authority and without the communication skills or dollars to confront a well-heeled nutraceutical industry. Sadly, until the 1994 Dietary Supplement and Health Education Act—which essentially freed the nutraceutical industry from FDA oversight—is repealed, consumers will continue to receive bad information that could lead to bad medical decisions, NCCAM or no NCCAM.